Oral Thrush

Oral thrush

Oral thrush is caused by a fungus called Candida that affects moist areas. The mouth is prone to this infection as it is always moist, or should be, in order to chew and start the digestion of food. Candida is a common organism and many people, particularly those who wear dentures, will not show any signs of thrush infection. This is because Candida does not normally overgrow because other organisms such as bacteria prevent it from rapidly growing and causing symptoms.

Infants and those that have under developed or weakened immune systems cannot fight infections easily and will often develop thrush as a result. Other people that are prone to infections will also be more likely to have thrush, such as diabetics, and those with poor nutrition or oral hygiene. Some antibiotics may occasionally cause thrush as the antibiotic has affected the helpful bacteria, as well as the infection it is treating. Other medicines, such as asthma preventer inhalers, may also cause thrush if the mouth is not rinsed out after they have been used.

Thrush usually develops as small white spots in the mouth which can become large if untreated. Infants appear to not have any other symptoms, but adults and older children often complain of pain or burning in their mouth, especially when eating or drinking.

Treatments for oral thrush are available from your community pharmacist. Adults and older children can usually use an antifungal gel or oral mixture that is applied to the mouth after eating and before bedtime. Infants are treated successfully by ensuring that milk is washed away from the mouth after a feed by giving them a little sterilised water to drink, or they may also use an oral antifungal mixture up to four times a day.

People with oral thrush need to ensure that they keep up their oral hygiene by continuing to brush their teeth twice a day with a soft toothbrush, even though their mouth is tender. Mouthwashes and gargles may also be helpful to rinse the mouth and throat, and to ease the pain of the infection.

If you are concerned about oral thrush, your community pharmacist has specific treatments that they can sell you without a prescription. Ensure that you complete the course of treatment that your pharmacist suggests and ask them for advice in order to prevent it returning. If you are using inhalers or other medicines that make you more likely to develop thrush, your pharmacist will advise you on the correct inhaler technique or other prevention strategies. They may refer you to a doctor, if required, to manage your condition. Most people find that oral thrush is easily treated and preventable, so consult your community pharmacist for help and advice.

Swallowing difficulties (dysphagia)

Causes of swallowing difficulties

Swallowing difficulties can happen at any age. There are a wide range of causes for them, including:

some medicines, such as antipsychotics
heartburn and acid reflux
cancer, such as mouth or throat cancers
nervous system or brain disorders
muscle disorders
blockages or structural issues with your mouth, throat or oesophagus.

Symptoms of swallowing difficulties

Symptoms of swallowing difficulties may include:

coughing or choking when eating or drinking
bringing food back up, may be through your nose
the feeling that food is stuck in your throat
having issues chewing your food
problems with dribbling.

Swallowing difficulties can cause weight loss, dehydration and chest infections.

Diagnosing swallowing difficulties

Let your healthcare provider know if you have swallowing difficulties. They will ask you about your symptoms and check if any other health conditions you have may be the cause.

Your healthcare provider may refer you to a specialist for tests. These may include a:

gastroscopy—a camera is passed down through your mouth to look at your throat and stomach
swallowing study—your throat and stomach are x-rayed as you swallow small amounts of food.

Treating swallowing difficulties

How your swallowing difficulties are treated depends on the cause and how severe it is. Treatments may include:

medicines to treat acid reflux
swallowing therapy with a speech and language therapist
making changes to what you eat and drink, such as softer foods and using thickener in drinks
using special spoons, plates and cups
surgery to widen your oesophagus.
using special medication lubricants eg Gloup to help make it easier to swallow tablets etc. For more information click here.

Self care for swallowing difficulties

As well as seeing your healthcare provider, the following tips may help you to get food or liquids into your stomach.

Sit upright in a chair—at a table is best.
Have regular small meals instead of the main large meals.
Eat or drink small mouthfuls at a time.
If your voice is gurgly when you eat or drink, give a small cough to make sure your airway is clear.
Wet food will be easier to swallow as dry food can catch in your throat.
If your food has 2 consistencies, such as fruit in juice and cereal in milk, try to mix it into 1 consistency, or eat the solid and liquid portions separately.
Concentrate on eating and avoid talking.
Hot, ice-cold or fizzy liquids are easier to swallow than room temperature liquids.
If you are told to have thickened liquids, avoid ice-cream and jelly as they thin before swallowing.
Drink from the top half of you cup to avoid tipping your head back.

Have a look at our range of Gloup medication lubricants here which can help with difficulties swallowing tablets...

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